The United States spends more per capita on health care than any place in the world but lags behind other wealthy nations in health and life expectancy, according to research published on Wednesday.
Japan still leads the world in terms of living the longest, with average life expectancy at 82.6 years in 2010, up from 79.1 years in 1990.
Americans are living longer too -- an average of 78.2 years compared to 75.2 two decades ago -- but were outpaced by other developed nations as the US ranking for life expectancy slid from 20th to 27th in the world.
Americans are also living with more health problems, ranging from chronic back pain to depression, said the study in the Journal of the American Medical Association.
Disease and disability account for nearly half the health burden in the United States, and poor diet, smoking, high blood pressure and physical inactivity are leading risk factors, it said.
"Individuals in the United States are living longer but are not necessarily in good health," said the study, called "The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors."
The research is based on data from 34 countries and includes estimates for death and disability from 291 diseases, conditions and injuries.
The United States spends twice as much as France on its average health care per person -- nearly $8,000 per capita in 2009, for 17.4 percent of US GDP -- according to the Organization for Economic Co-operation and Development.
But France ranks much higher than the United States for life expectancy -- ninth in the world with an average age for both sexes combined of 80.9.
"The United States spends more than the rest of the world on health care and leads the world in the quality and quantity of its health research, but that doesn't add up to better health outcomes," said Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME) and one of the lead authors on the study.
"The country has done a good job of preventing premature deaths from stroke, but when it comes to lung cancer, preterm birth complications, and a range of other causes, the country isn't keeping pace with high-income countries in Europe, Asia, and elsewhere."
A separate study by IHME, an independent research organization at the University of Washington, in the journal Population Health Metrics, found that Americans are exercising more than they did at the start of the century but obesity is still rising.
"As physical activity increased between 2001 and 2009, so did the percentage of the population considered obese," the group said in a statement.
Among US men, obesity prevalence was 26.1 percent in 2001 and 32.8 percent in 2009, a rise of 6.7 percentage points.
For US women, obesity prevalence was 28.7 percent in 2001 and 35.1 percent in 2009, a change of 6.4 percentage points.
"It's quite disappointing that the US is falling behind in outcomes for diseases, such as cardiovascular disease, and especially those diseases with preventable causes," said cardiologist Robert Rosenson, director of cardiometabolic disorders at The Mount Sinai Medical Center.
"We need to make a major effort to make better lifestyle choices daily based on diet," he added. "The costs due to poor eating and disabling health conditions are overtaxing our society."